Pathology of the breast Flashcards
Name the disorders of breast development
- Milk line remnants: Extra breasts or nipples
- Accessory axillary breast tissue: Normal ductal system extends beyond normal breast area
- Congenital nipple inversion: Failure of nipple to evert during development
What are mammograms used for
They are used to detect small, non palpable and asymptomatic breast carcinomas - Principle signs are densities and calcifications
Most common means to detect breast cancer
Explain the benign inflammatory disorders of the breast
- Acute mastitis: Lactating women, Staph aureus, abscess/acute inflammation
- Chronic mastitis: Lymphocytic mastopathy, Granulomatous mastitis
- Duct ectasia: Women 50-60, retro-areolar mass associated with thick white nipple discharge
- Fat necrosis: Painless palpable mass with skin thickening or retraction
Explain fibrocystic change in the breast
Lumpy bumpy to palpitation
Breast is dense and contains cysts on radiography
Pathologically there are cysts, fibrosis, adenosis
What is the characteristic of non-proliferative changes in the breast
Increase in fibrous stroma
Dilation of the ducts
Cysts formation
What happens in sclerosing adenosis
Involved duct unit is enlarged, acini are compressed and distorted by dens stroma
Which conditions pose no additional or minimal risk for breast carcinoma
- Fibrosis
- Cystic changes
- Apocrine metaplasia
- Mild hyperplasia
Which conditions are associated with 2x increased risk for breast carcinoma
- Moderate to florid hyperplasia
- Ductal papilomatosis
- Sclerosing adenosis
- Fibroadenomas
Which conditions carry a significant (5x) risk for developing breast carcinoma
- Atypical hyperplasia
- Positive family history increase the risk (10x)
Explain fibroadenoma
Common benign tumour
Young women - 3rd decade of life
Relatove increase in estrogen
Discrete nodule
Well encapsulated
Explain phylloides tumour
Arise from interlobular stroma or rarely from existing fibroadenoma
Leaflike clefts and slits
Usually benign
Cured by excision
Explain Intraductal papilloma
Subareolar tumour
Neoplastic papillary growth within a duct
Bloody nipple discharge
Nipple retraction
What are the risk factors for breast carcinoma
Age
Age at menarche
Age at first live birth
First-degree relatives with breast cancer
Atypical hyperplasia
Race/ethnicity
Which genetic conditions predispose to carcinoma of breast
BRCA1 mutations on chromosome 17q21.3
Li frumeni syndrome: germ line mutation TP53
Cowden disease - germ line mutation in PTEN
Carriers of ataxia-telangiectasia gene
Which features are common in all invasive cancers of the breast
- Adherent to pectoral muscle with fixation
- Adherent to overlying skin with retraction of nipple
- Lymphoedema
- Peau d’orange
- Spread via lymphatics
